青少年Ⅰ型神经纤维瘤病性脊柱侧凸患者Cobb角与骨密度的相关性分析  

The correlation between Cobb angle and bone mineral density in patients with adolescent neurofibromatosis 1 scoliosis

作　　者：束昊[1] 邱勇[1] 孙超[1] 刘文军[1] 王信华[1] 俞杨[1] 朱泽章[1] 

机构地区：[1]南京大学医学院附属鼓楼医院脊柱外科,江苏省南京市210008

出　　处：《中国脊柱脊髓杂志》2010年第5期363-366,共4页Chinese Journal of Spine and Spinal Cord

基　　金：江苏省人事厅六大人才高峰项目(07-B-027)

摘　　要：目的：探讨骨密度与青少年Ⅰ型神经纤维瘤病（neurofibromatosis1,NF-1）性脊柱侧凸患者Cobb角的关系。方法：NF-1伴脊柱侧凸组共有患者18例,年龄10-18岁,平均14.9岁,侧凸Cobb角40°-132°（平均81.4°）;同年龄非脊柱畸形患者（对照组）25例,年龄11-19岁,平均15.6岁,所有研究对象均行双能X线吸收仪测量非优势侧的股骨近端和腰椎（L2～L4）的骨密度（bone mineral density,BMD）,将两组受试者的测量结果进行t检验比较,并对NF-1伴脊柱侧凸组患者的BMD检测结果与侧凸Cobb角进行相关性分析。结果：两组受试者在年龄、性别比例无明显差异（P〉0.05）,青少年NF-1伴脊柱侧凸患者所测各部位的骨密度均明显低于对照组（P〈0.01）,腰椎（L2～L4）平均骨密度（0.61g/cm^2）明显低于对照组（1.03g/cm^2）,腰椎骨密度的降低比股骨明显,NF-1伴脊柱侧凸组患者腰椎及非优势侧股骨近端BMD与侧凸Cobb角无显著性相关（P〉0.05）。结论：青少年NF-1伴脊柱侧凸患者存在全身性的骨量减低,其与侧凸的严重程度无关,可能与NF-1伴脊柱侧凸的发病机理有关。Objective：To evaluate the relationship between bone mineral density（BMD） and the patients with scoliosis secondary to neurofibromatosis 1（NF-1）.Method：18 individuals with adolescent neurofibromatosis 1 scoliosis with mean age of 14.9 years（range,10 to 18 years） and mean Cobb angle of 81.4°（range,40° to 132°） were reviewed retrospectively,while 25 adolescents with mean age of 15.6 years（range,11 to 19 years） undergoing spinal surgery were selected as control.BMD of the lumbar spine（L2-L4） and proximal femur was measured using dual energy X-ray absorptiometry in both groups.BMD in two groups was tested by t-test,and the relationships between BMD of the adolescent neurofibromatosis 1 scoliosis and Cobb angle was assessed using correlation analysis.Result：No age and sex ratio related difference were noted in two groups（P〉0.05）.However,the BMD of the lumbar spine and proximal femur in patients who had adolescent neurofibromatosis 1 scoliosis was significantly different from those in control group（P〈0.01）,in patients with NF-1,the reduction of BMD in lumbar spine was more remarkable than that in proximal femur.Furthermore,the BMD of the lumbar spine and proximal femur in NF-1 patients had no significant correlations with Cobb angle（P〉0.05）.Conclusion：Osteoporosis in patients with adolescent neurofibromatosis 1 scoliosis is not correlative with the severity of the neurofibromatosis 1 scoliosis.However,it may be caused by the inner mechanism.

关 键 词：Ⅰ型神经纤维瘤病 脊柱侧凸 青少年 骨密度 

分 类 号：R682.3[医药卫生—骨科学] R596.1[医药卫生—外科学]